Prenatal medication for opioid use disorder helps discharge infants back to mothers

1. In this study, medication prescribed for opioid use disorder amongst pregnant women often allowed newborn infants to be discharged to their parents, rather than relatives or foster care.

2. However, more than half of eligible women in this study did not receive medication for opioid use disorder.

Evidence Rating Level: 3 (Average)

Opioid use during pregnancy has increased steadily since the 2000s in the United States and remains a serious issue with no clear answer. Opioid use during pregnancy can lead to several adverse events including maternal adverse events as well as neonatal opioid withdrawal syndrome (NOWS). Medication for opioid use disorder (MOUD) is the standard treatment for opioid use disorder, includes medications such as methadone and buprenorphine. The purpose of this study was to identify maternal and neonatal factors associated with use of MOUD and determine the impact of receipt of MOUD on discharge to parents for infants born with NOWS.

This study used data from 3 Alaska, United States hospitals: Alaska Native Medical Center, Yukon Kuskokwim Delta Regional Hospital, and Fairbanks Memorial Hospital from July 2016-December 2019. From this dataset, only infants born with NOWS as defined by the Finnegan Neonatal Abstinence Scoring System were included (n=193). Infants were excluded if they were <36 weeks gestation or had any major birth defects. MOUD, whether the infant was discharged home to parents, maternal and perinatal care characteristics were recorded.

The results demonstrated that receiving MOUD during pregnancy increased the odds of an infant with NOWS being discharged home to parents by 4 times, indicating that MOUD during pregnancy may help keep families together. However, more than half of the mothers did not receive MOUD in this study, indicating need for greater access. However, this study was limited, as its relatively small sample size, and selective inclusion of clinics in Alaska. Despite these limitations, the results suggest that MOUD during pregnancy may help keep families together during discharge planning.

Click to read the study in the Journal of Addiction Medicine

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